The decision to undergo a breast augmentation or a breast reconstruction for breast cancer surgery is a deeply personal one, often influenced by a myriad of factors, including self-esteem, body image, and lifestyle. Over time, natural breasts change in breast size and shape, usually the result of breastfeeding or age-related breast sagging. Others may require breast cancer surgery to treat cancer. Deciding on a cosmetic breast augmentation or a breast reconstruction using an implant is a pivotal decision filled with questions.

A crucial aspect that accompanies this decision is understanding the timeline and maintenance necessary for breast implants. The notion that implants are ‘one-and-done’ can be a common misconception. It’s time to debunk the myths and provide facts for those considering implant surgery. Dr. Amir Ghaznavi, a dual-boarded plastic surgeon and founder of AMG Plastic Surgery in Herndon, VA, provides expert insight on breast implants’ longevity, replacement, and safety.

Understanding Longevity

Breast implants are not designed to last a lifetime. According to the American Society for Aesthetic Plastic Surgery (ASAPS), approximately 25% of women require revision surgery or more surgery to correct breast implant issues within ten years of their initial placement.

The Average Life Span of Breast Implants

Before understanding if and when to replace breast implants, it’s essential to recognize that nothing lasts forever — and that includes breast implants. However, modern advancements have significantly extended the lifespan of breast implants. The typical duration one can expect from an implant is not uniform for all, as different factors affect longevity.

Types of Implants

Today, there are three predominantly used types of breast implants: saline, silicone gel-filled, and structured implants. A structured implant is a type of saline implant that has an inner structure to control the movement of the saline within.

Saline Implants

Saline-filled implants are filled with sterile saltwater composed of a silicone shell. Should they rupture, the saline is harmlessly absorbed by the body. They tend to have a firmer feel than silicone implants.

Silicone Implants

Silicone-filled implants are filled with a silicone gel that feels similar to natural breast tissue. If these implants rupture, the gel may remain within the implant shell, or it might escape into the scar tissue pocket. Silicone gel-filled implants come in different cohesivity, determining how soft or firm the implants are.

Structured Saline Implants

These contain two lumens filled with saline, separated by a silicone barrier. This design is intended to create a more natural feel but reduces the chance of the rippling that’s often seen with saline implants.

Material Filled – What’s Inside Your Implants?

Understanding the components of each type of implant is crucial, as it can influence how long an implant might last and when it needs to be replaced. The fill materials mentioned above significantly affect how the implant feels and responds over time.

Do Breast Implants Really Need Replacement in 10 Years?

The 10-year mark is often touted as the “expiration date” for breast implants, but this is misleading. In truth, no specific medical consensus or manufacturer recommendation has cited a mandatory 10-year interval for implant replacement.

The Myth Explained

The concept of a 10-year replacement cycle may have originated from early manufacturers’ warranty periods, which averaged around 10 years. This should not, however, be interpreted as a medical requirement to have breast implant surgery. Rather, individuals with implants should monitor their condition over time and be aware of potential changes.

Monitoring for Best Practices

Regular self-exams and visits to Dr. Ghaznavi for periodic checks become vital practice. It’s important to be attentive to any changes in your implants’ shape, feel, or symmetry, which could indicate an implant rupture or the onset of capsular contracture.

Warning Signs That It’s Time for a Replacement

The decision to replace an implant should be based on a variety of signs and not necessarily an arbitrary timeframe. Understanding these indicators is critical for maintaining your breast health.

Implant Rupture

A rupture is a hole or tear in the implant’s shell that may cause deflation or changes in the breast shape.  If a saline implant ruptures, the saline solution will be reabsorbed by the body and cause noticeable changes in the implant.

A silicone breast implant rupture is harder to detect, as the gel may remain trapped in the surrounding tissue. Regular MRI screenings or an ultrasound can help identify these “silent ruptures.” The modern generations of silicone implants are composed of highly cohesive gel or “gummy bear” implants, further reducing the likelihood of gel leakage in the event of a rupture.

If there is a ruptured implant, it is not a medical emergency. In the case of saline implant rupture, your body will absorb the saline. Breast implant removal or breast implant replacement surgery are handled as an outpatient procedure with little downtime. Additional surgery maybe required if a breast lift is included.

In the case of silicone gel ruptures, it depends on the intracapsular vs extracapsular rupture. Intracapsular rupture is when the gel remains trapped in the “capsule,” or scar tissue that typically forms around implants, and extracapsular rupture is when the gel leaks out of this capsule. An extracapsular rupture can potentially lead to silicone migration, causing inflammation or lumps in other areas of the body. Both require surgery. However, extracapsular rupture should be addressed sooner rather than later.

If you have any concerns that one or both of your implants may have ruptured, schedule a visit with Dr. Ghaznavi as soon as possible for evaluation for breast implant removal.

Capsular Contracture

Capsular contracture occurs when the scar tissue or the capsule that typically forms around an implant begins to tighten and squeeze the implant. This can cause discomfort, distortion of the breasts, and, in severe cases, pain and hardening. A patient can develop capsular contracture anytime after a breast augmentation surgery or reconstructive surgery, but it is more likely to happen within the first few years.

There are different grades or levels of capsular contracture, from mild to severe. The severity is determined by how much the capsule tightens around the breast implant and the level of discomfort experienced by the patient. When a patient starts to feel severe pain or distortion of the breasts due to the contraction, surgery may be necessary.

To prevent capsular contracture, following all post-operative care instructions provided by Dr. Ghaznavi is important. Your surgeon’s instructions include massage techniques to help keep the capsule soft and regular check-ups to monitor for any changes in the breast tissue.

Bottoming Out

Bottoming out is a condition in which the breast implant shifts downward, causing the nipple to appear too high on the breast or for more of the breast implant to be visible on the bottom of the breast. This can happen due to stretching of the skin and tissue over time due to implant size or by surgical error.

In cases of bottoming out, surgery may be necessary to reposition the breast implant and correct the appearance of the breasts. It is important to address bottoming out as soon as possible, as it can cause discomfort and affect the overall aesthetic outcome of the procedure.

Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)

Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is a rare but serious condition that has been linked to breast implants, most commonly aggressively textured implants. While not breast cancer, it is a type of non-Hodgkin’s lymphoma that can develop in the scar tissue around the breast implant.

Symptoms of BIA-ALCL may include swelling, pain, lumps, or breast asymmetry. If you experience any of these symptoms, it is important to consult with Dr. Ghaznavi for further evaluation and testing.

While anaplastic large cell lymphoma is rare, it is important to be aware of the potential risks associated with textured breast implants. Discussing all options and potential risks with BIA-ALCL before undergoing any procedure is always recommended.

Exploring the Safety of Breast Implants

The safety of implants is an ongoing topic of discussion within the medical community. Recently, there’s been increased scrutiny on the long-term safety of both silicone and saline breast implants.

Are They Safe?

Yes. The majority of breast implant patients after breast augmentation or reconstruction do not encounter significant complications. Breast implants have been on the commercial market for many years and have been one of the most vigorously tested medical devices. However, like any medical device, they risk complications, including surgery-related complications.

Long-Term Complications

Studies have shown that some patients may experience problems such as silicone implant ruptures, saline implant deflation, breast pain, infection, and asymmetry. While these issues are typically manageable and do not jeopardize overall health, they can lead to long-term worries.

Systemic Illness

One of the main concerns surrounding breast implants is the development of systemic illnesses, such as autoimmune diseases. However, current research does not support a direct link between breast implants and these conditions.

A small segment of patients do report systemic issues such as headaches, chest pain, chronic fatigue, joint pain, skin rash, and other vague symptoms after placement of their implants. This constellation of symptoms is sometimes referred to as breast implant illness (BII) or autoimmune/inflammatory syndrome induced by adjuvants (ASIA). More research is needed to fully understand the potential connection between implants and breast implant illness after breast augmentation. There is no consensus among plastic surgeons regarding the surgical removal for treatment of BII.

Navigating FDA Recommendations and Beyond

The FDA has an essential role in regulating the safety of medical devices, including breast implants. In recent years, their focus has been on post-approval studies regarding the long-term safety and performance of saline or silicone breast implants for breast augmentation or breast reconstruction after breast cancer.

Current Guidance

It’s important to stay updated on the FDA’s recommendations regarding breast implants. The FDA recommends imaging to detect silent rupture on silicone breast implants starting five to six years post-surgery and every two or three years after that with either an MRI scan or an Ultrasound. There are no imaging recommendations for saline implants.

Ensuring Your Implants Last: A Personal Responsibility

The well-being of your breast implants is not solely the responsibility of manufacturers or surgeons; it’s a partnership among all stakeholders.

Post-Operative Care

Following Dr. Ghaznavi’s post-operative instructions, attending routine follow-up appointments, and communicating concerns promptly are all individual actions that contribute to the longevity of breast implants.

Maintenance and Support

Leading a healthy lifestyle, maintaining a stable body weight, and protecting your chest area from trauma all support the durability of breast implants.

Conclusion: Longevity, Not Infinity

Breast implants are designed with longevity in mind but are not perpetual fixtures or lifetime devices. Understanding their lifespan, remaining vigilant to potential complications, and following the FDA guidelines and Dr. Ghaznavi’s advice ensure that your breast implants serve you well for as long as possible.

In essence, the decision to have your implants removed or replaced should be personalized, taking into account several factors, such as the breast implant type, your health, and lifestyle. With the right mindset and continued care, your breast augmentation surgery or reconstructive surgery experience can be beautiful and long-lasting.

Remember, the best implant is an informed patient. Stay informed, stay empowered, and take responsibility for the longevity of your breast implants. So don’t be afraid to ask questions and seek guidance from Dr. Amir Ghaznavi during your personalized consultation at AMG Plastic Surgery. With proper care and attention, you can enjoy the benefits of breast implant surgery for many years to come.